SUSAC Member Form
Please fill in the boxes below in as much detail as required. It will be kept confidential within SUSAC.

The information provided on this form will enable us to:                                                                                                                
     Sort out the Trip Notification Forms for the Union without bugging you constantly.
     Have your full correct preferred email address for general information.
     Have the correct phone number for yourself and your emergency contact.
     Be able to train, as a lot of the information is required by Sport Sheffield (and isn't just us being nosy).

Anything you tell us can be retracted from our records if you so wish at any time.
It can also be updated if it changes, like an emergency contact.

So please, fill in the form. Many thanks.

The questions without a red asterix to the right are not required and can be left blank.

If you don't understand any of the questions, email secretary@susac.com
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Full Name *
Prefered Name
Phone Number. Add area codes too if it is for outside the UK. *
This is extremely useful when trying to get hold of you regarding trips you signed up for or training.
Alternative Phone Number
Some people might have a work phone. We wouldn't contact you using this unless absolutely necessary.
Email *
This will be put on our mailing list, but also used to contact you directly if need be. Promise we won't spam you. If you put your uni email (@sheffield.ac.uk) for this answer we do require you give us another below as an alternative.
Alternative Email
Address *
Term time address please.
Alternative Address
Any address you would be at outside of term time that isn't the above.
Date of Birth *
MM
/
DD
/
YYYY
Name of Emergency Contact *
Someone who can make medical decisions on your behalf in the unlikely event of an accident.
Relationship to Emergency Contact *
Phone Number of Emergency Contact.  Add area codes too if it is for outside the UK. *
Full Address of Emergency Contact. (house number, road, city, postcode) or something similar. *
Alternative Phone Number of Emergency Contact *
Current University of Sheffield Status *
Graduation Due, Type N/A if Not Applicable *
Example.  July 2022
UCARD Number, Type N/A if Not Applicable *
This can be found on your UCARD and is different to your registration number.
Highest BSAC Qualification Achieved *
Highest BSAC Instructor Qualification Achieved *
Highest Non-BSAC Qualification and Oganisation
If you have any previous diving qualifications from other agencies. eg. PADI Open Water
Highest Non-BSAC Instructor Qualification and Organisation
If you have any previous instructor diving qualifications from other agencies. eg. SSI Advanced Open Water Instructor
Completed First Aider or Medic Training *
Do You Hold a UK Car Driving Licence *
Do You Hold a UK Minibus Driving Licence *
Do You Own a Vehicle? *
Are You Willing to Drive a Hire Vehicle for SUSAC? *
How did you hear about the club? *
Any Other Information You Think We Should Know About You
I Have Read and Agree to Comply to SUSAC Risk Assessment *
I Have Read and Agree to Comply with SUSAC Trip Policy *
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